| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
11,332 |
10,986 |
$403K |
| 92015 |
Determination of refractive state |
13,515 |
13,192 |
$215K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
5,090 |
4,943 |
$178K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
2,001 |
1,852 |
$72K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,432 |
1,280 |
$43K |
| 92133 |
|
2,508 |
2,401 |
$32K |
| 92083 |
|
1,569 |
1,511 |
$26K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
235 |
220 |
$12K |
| 92250 |
|
388 |
374 |
$11K |
| 92134 |
|
802 |
761 |
$10K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
555 |
536 |
$10K |
| 83861 |
|
1,200 |
663 |
$9K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
110 |
106 |
$7K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
206 |
193 |
$7K |
| 92002 |
|
140 |
140 |
$5K |
| 68761 |
|
95 |
81 |
$4K |
| 92136 |
|
221 |
209 |
$3K |
| 92020 |
|
263 |
242 |
$3K |
| 92025 |
|
51 |
50 |
$404.31 |
| 92341 |
|
13 |
13 |
$200.00 |
| 76514 |
|
29 |
26 |
$170.87 |
| V2020 |
Frames, purchases |
2,923 |
2,872 |
$40.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,530 |
1,280 |
$34.20 |
| V2760 |
Scratch resistant coating, per lens |
695 |
355 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
569 |
288 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
1,111 |
556 |
$0.00 |
| A4263 |
Permanent, long term, non-dissolvable lacrimal duct implant, each |
73 |
64 |
$0.00 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
24 |
12 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,287 |
1,133 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
559 |
283 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
361 |
184 |
$0.00 |
| V2299 |
Specialty bifocal (by report) |
266 |
132 |
$0.00 |
| V2781 |
Progressive lens, per lens |
278 |
138 |
$0.00 |